Individual
LEAH A MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, DEPT. OF PEDIATRICS, PORTLAND, ME 04102-3134
(207) 662-2541
(207) 662-3172
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2541
(207) 662-3172
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
226905
MA
208000000X
Pediatrics Physician
Primary
MD17508
ME
Other
Enumeration date
07/17/2006
Last updated
01/02/2013
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